Healthcare Provider Details

I. General information

NPI: 1114501046
Provider Name (Legal Business Name): GIANPAOLO FEMINO APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 S DURANGO DR
LAS VEGAS NV
89117-9186
US

IV. Provider business mailing address

6332 BELGIUM DR
LAS VEGAS NV
89122-1909
US

V. Phone/Fax

Practice location:
  • Phone: 702-901-4233
  • Fax:
Mailing address:
  • Phone: 702-338-4935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number837862
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: